Provider Demographics
NPI:1295212603
Name:ANTOLIK, ASTER MORIAH (RN)
Entity type:Individual
Prefix:MRS
First Name:ASTER
Middle Name:MORIAH
Last Name:ANTOLIK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ASTER
Other - Middle Name:MORIAH
Other - Last Name:GREATHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:16555 N 99TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2366
Mailing Address - Country:US
Mailing Address - Phone:985-778-1087
Mailing Address - Fax:
Practice Address - Street 1:16555 N 99TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2366
Practice Address - Country:US
Practice Address - Phone:985-778-1087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN209316163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool